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<!--bt end--> <div class=time>08-03-07 17:05:06　　　www.39.net　　　39</div> <!--time end--> <div class=key>关键è¯ï¼š<a href='/List.aspx?chid=18&Keyword=%e6%89%8b%e6%9c%af&FieldName=tagnamestr' target='_blank'>手术</a></div> <!--key end--> <div class=daodu></div> <!--ad end--> <div class=geyan><label><span>å¥åº·è°šè¯­</span></label></div> <!--geyan end--> <div class=concent fang=08-03-07 17:05:06> <br> <p>çƒéƒ¨å°¿é“æŸä¼¤ä¿®å¤æœ?/p> <img border="0" src="../../Files/Shoushu/200812714424315677801.jpg" > ⑴会阴部切å£åŠçºµè¡Œåˆ‡å¼€çƒæµ·ç»µä½“è‚? <img border="0" src="../../Files/Shoushu/200812714424320377802.jpg" > ⑵显露尿é“裂å? <img border="0" src="../../Files/Shoushu/200812714424323477803.jpg" > ⑶寻到尿é“近侧断端åŽï¼Œæ’入导尿管 <img border="0" src="../../Files/Shoushu/200812714424323477803.jpg" > ⑷如ä¸èƒ½æ’入，则ç»è†€èƒ±æ’入金属探å­ï¼Œæ˜¾éœ²å°¿é“近侧断端 <img border="0" src="../../Files/Shoushu/200812714424326577804.jpg" > ⑸ç¼åˆå°¿é“åŽå£ï¼Œå¯¼å°¿ç®¡æ’入膀胱åŽï¼Œç¼åˆå‰å£? <img border="0" src="../../Files/Shoushu/200812714424331277805.jpg" > ⑹出血者作间断褥å¼ç¼åˆ å›?　çƒéƒ¨å°¿é“æŸä¼¤ä¿®å¤æœ? <p>[适应è¯]</p><p>1.å°¿é“æŸä¼¤è¾ƒé‡è€Œåˆæ”¾ä¸è¿›å¯¼å°¿ç®¡è€…，需施行尿é“å»åˆæœ¯ï¼ˆåŒ…括çƒéƒ¨å°¿é“ä¿®å¤æœ¯ï¼ŒåŽå°¿é“ä¿®å¤æœ¯ï¼‰ã€?/p><p>2.å°¿é“æŸä¼¤åˆå¹¶ç›†éª¨éª¨æŠ˜è€…，截石ä½å¯åŠ é‡éª¨æŠ˜ç§»ä½ï¼Œå¯¼è‡´ä¸¥é‡å¹¶å‘症，故应é¿å…施行尿é“å»åˆæœ¯ï¼Œè€Œè¡Œä¼šå¸ˆæœ¯æˆ–耻骨上膀胱造瘘术ã€?/p><p>3.åˆå¹¶ç›†éª¨éª¨æŠ˜ã€ç›´è‚ ç ´è£‚ã€ä¸¥é‡ä¼‘克者，也å¯å…ˆè¡Œè€»éª¨ä¸Šè†€èƒ±é€ ç˜˜æœ¯ã€ç»“肠造瘘术，留待以åŽè¿›è¡Œå°¿é“ä¿®å¤ã€?/p><p>4.早期开放性尿é“çƒéƒ¨æŸä¼¤ï¼Œç¼ºæŸè¾ƒçŸ­æ—¶ï¼Œå¯è¡Œå°¿é“断端å»åˆæœ¯ï¼›ç¼ºæŸè¾ƒé•¿æ—¶ï¼Œåˆ™åº”行皮æ¡åŸ‹è—会阴尿é“造å£æœ¯ã€?/p><p>[术å‰å‡†å¤‡]</p><p>1.术å‰çº æ­£ä¼‘å…‹ã€?/p><p>2.术å‰å·²åˆå¹¶æ€¥æ€§å°¿æ½´ç•™ï¼Œç—…人呻åŸä¸èƒ½è€å—时，为预防尿外渗和å‡è½»ç—…人痛苦，å¯å…ˆè¡Œè†€èƒ±ç©¿åˆºï¼ŒæŠ½å‡ºå°¿æ¶²ã€?/p><p>[麻醉]</p><p>腰麻或硬膜外阻滞麻醉。åˆå¹¶ä¼‘克者å¯é€‰ç”¨å…¨éº»ã€?/p><p>[手术步骤]</p><p>1.体ä½ã€€æˆªçŸ³ä½ã€?/p><p>2.切å£ã€€ä¼šé˜´å¼§å½¢åˆ‡å£ï¼Œç›´è¾¾ä¼šé˜´æµ…筋膜ã€?/p><p>3.显露尿é“裂å£ã€€äºŽä¸­çº¿çºµè¡Œåˆ‡å¼€ä¼šé˜´æ·±ç­‹è†œåŠçƒæµ·ç»µä½“è‚Œ[å›? â‘´]，清除血肿，显露尿é“海绵体。由尿é“å£æ’入一根较粗的导尿管或金属探å­ï¼Œä½¿å…¶åœ¨æŸä¼¤éƒ¨ä½éœ²å‡ºï¼Œæ˜¾éœ²å°¿é“裂å£[å›? ⑵]。将尿é“海绵体沿阴茎筋膜下分离，修整创缘，切除无生机的组织ã€?/p> <p>4.寻找近端尿é“　于耻骨上挤压膀胱，尿液在伤å£åŒºæµå‡ºä¹‹å¤„å³ä¸ºå°¿é“近端所在部ä½ï¼Œå¯ç”¨å¯¼å°¿ç®¡è¯•è¡Œæ’å…¥[å›? ⑶]。如ä»ä¸èƒ½æ’入，应在耻骨上切开膀胱作会师术，用金属探å­ç”±è†€èƒ±åˆ‡å£ç»è†€èƒ±é¢ˆåˆ°è¾¾å¹¶æ˜¾éœ²å°¿é“近侧断端[å›? â‘·]ã€?/p> <p>5.æ’入导管ã€å»åˆå°¿é“断端　å°?8ï½?0å·æ°”囊导尿管自尿é“å£æ’至尿é“远侧断端，å†ç”±è¿‘侧断端æ’入膀胱，囊内充以消毒ç›æ°´15ml，以å…脱出。用3%铬制肠线作尿é“对端全层间断ç¼åˆï¼›å…ˆç¼åˆåŽå£ï¼Œç„¶åŽç¼åˆå‰å£ï¼Œçº¿ç»“打在外é¢ï¼Œå…?ï½?é’ˆå³å¯[å›? ⑸]。如é‡å°¿é“海绵体出血甚多时，å¯åšå…¨å±‚褥å¼ç¼åˆ[å›? ⑹]ã€?/p> <p>6.ç¼åˆã€€ç”?-0ä¸çº¿ç¼åˆçƒæµ·ç»µä½“肌，伤å£ç½®èƒ¶çš®ç‰‡å¼•æµåŽç¼åˆä¼šé˜´éƒ¨åˆ‡å£ã€?/p><p>7.引æµå°¿æ¶²ã€€è†€èƒ±æœªåˆ‡å¼€è€…，留置气囊导尿管，以防脱出；膀胱切开者，除尿é“留置导尿管外，膀胱内留置伞状导管，两管用ä¸çº¿è¿žæŽ¥ã€‚耻骨åŽé—´éš™æ”¾é¦™çƒŸå¼•æµä¸€æ¡ã€?/p><p>[术åŽå¤„ç†]</p><p>1.术åŽå°¿é“扩张是尿é“æŸä¼¤åŽæžä¸ºé‡è¦çš„一环。尿é“内留置的导尿管äº?ï½?周åŽæ‹”除，隔日应å³è¡Œå°¿é“扩张术。以åŽæ¯éš?ï½?日扩张一次；间歇期é€æ¸å»¶é•¿ï¼Œç”±7ï½?0æ—¥ã€?4日到1个月ã€?个åŠæœˆã€æ•°æœˆï¼Œä¸€èˆ¬éœ€åšæŒæ‰©å¼ 1ï½?å¹´ã€?/p><p>2.å¿…é¡»ä¿æŒå¼•æµå°¿æ¶²çš„管é“通畅ã€?/p><p>3.必须使用抗生素控制感染，尿é“å£åº”以酒精棉çƒå®šæœŸæ¶ˆæ¯’，以防留置导尿管期间å‘生急性附ç¾ç‚ŽåŠç¾ä¸¸ç‚Žã€?/p><p>4.会阴部引æµèƒ¶çš®ç‰‡å¯äºŽ24å°æ—¶åŽå–出，耻骨åŽé¦™çƒŸå¼•æµ?8å°æ—¶åŽå–出ã€?/p><p>5.膀胱造瘘管å¯äºŽå°¿é“扩张进行顺利åŽå–出ã€?/p><p>　</p> </div> <!--concent end--> <div class=next> <p><a href="http://www.whrenai.com/ssdq/mnszwk/70636.html">分期尿é“下裂修å¤æœ?/a></p> <p><a href="http://www.whrenai.com/ssdq/mnszwk/70638.html">åŽå°¿é“æŸä¼¤ä¿®å¤æœ¯</a></p> </div> <!--next end--> <div class=fanhui><a href="http://www.whrenai.com"><img src="http://images.whrenai.com/news_images/back.gif" 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